Eyeworld

JUNE 2022 | EYEWORLD | 19 space would be one explanation for this associ- ation. Intraoperative difficulties were associated with higher risk. Some limitations of this study include inability to assess features not included in the database (e.g., previous intravitreal injection, use of medications that could cause floppy iris syndrome). The data reported here is voluntary and reported by clinics, creating the potential for underreporting. Finally, there was a signifi- cant loss of data of about 1.1 million patients, although there were no significant differences in the demographics between these groups. Overall, the data show that PCR is becom- ing a rarer complication, but there are preop- erative and intraoperative factors that can help identify patients at greatest risk of PCR. Iden- tifying these factors will not only help counsel patients appropriately but also help determine which patients are not appropriate for junior trainees. during the study period as well as more ex- perience among the surgeons providing data. Though each year added only minimal risk, an 80-year-old would have 20% higher odds of a PCR than a 55-year-old patient. Age as a risk factor was present in most of the other studies as well. Other ocular diseases were also associ- ated with higher risk. Diabetes has been shown as a risk factor, and other studies have specifi- cally shown previous intravitreal injections are associated with higher risk of PCR. 6,8,9 Glaucoma was shown to be significant in previous studies, but one found that exclusion of pseudoexfolia- tion made the findings not significant. 10,11 In this study, glaucoma and pseudoexfoliation syn- drome were associated with higher risk of PCR. In terms of refraction, hyperopic targets had higher risk while myopic targets had a decreased risk. Some previous studies looking at axial length did show higher PCR with short- er axial lengths, but results with myopic were more conflicting. 10–12 The narrower working rupture in cataract surgery as reflected in for Cataract and Refractive Surgery" Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery Segers MHM, et al. J Cataract Refract Surg. 2022;48(1):51–55. n Purpose: To analyze the incidence and risk factors of posterior capsule rupture (PCR) in cataract surgery n Setting: European clinics affiliated with the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) n Design: Retrospective cross-sectional register-based study n Methods: Data was obtained from the EUREQUO. The database contains data on demographics, comorbidities, and intraoperative complications, including PCR for the study period from January 1, 2008, to December 31, 2018. Univariable and multivariable logistic regression analyses were performed to estimate the (adjusted) odds ratio (OR) and 95% confidence intervals (CI). n Results: Data was available for 2,853,376 patients, and 31,749 (1.1%) cataract surgeries were complicated by a PCR. The PCR rate ranged from 0.60–1.65% throughout the years, with a decreasing trend (p<0.001). The mean age of the PCR cohort was 74.8±10.5 years, and 17,629 (55.5%) patients were female. Risk factors most significantly associated with PCR were corneal opacities (OR 3.21, 95% CI 3.02– 3.41, p<0.001), diabetic retinopathy (OR 2.74, 95% CI 2.59–2.90, p<0.001), poor preoperative visual acuity (OR 1.98, 95% CI 1.88–2.07, p<0.001), and white cataract (OR 1.87, 95% CI 1.72–2.03, p<0.001). n Conclusion: Risk factors for PCR were identified based on the EUREQUO, and the incidence of this complication is decreasing over time. References 1. Taylor HR. Cataract: how much surgery do we have to do? Br J Oph- thalmol. 2000;84:1–2. 2. Jaycock P, et al. The Cataract Na- tional Dataset electronic multi-centre audit of 55,567 operations: updating benchmark standards of care in the United Kingdom and internationally. Eye (Lond). 2009;23:38–49. 3. Chan E, et al. Complications of cataract surgery. Clin Exp Optom. 2010;93:379–389. 4. Segers MHM, et al. Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery. J Cataract Refract Surg. 2022;48:51–55. 5. Zetterberg M, et al. Cataract surgery volumes and complications per surgeon and clinical unit: data from the Swedish National Cataract Register 2007 to 2016. Ophthalmolo- gy. 2020;127:305–314. 6. Shalchi Z, et al. Risk of posterior capsule rupture during cataract surgery in eyes with previous intra- vitreal injections. Am J Ophthalmol. 2017;177:77–80. 7. Day AC, et al. The Royal College of Ophthalmologists' National Ophthal- mology Database study of cataract surgery: report 1, visual outcomes and complications. Eye (Lond). 2015;29:552–560. 8. Lee AY, et al. Previous intravitreal therapy is associated with increased risk of posterior capsule rupture during cataract surgery. Ophthalmol- ogy. 2016;123:1252–1256. 9. Chancellor J, et al. Intraoperative complications and visual outcomes of cataract surgery in diabetes mellitus: a multicenter database study. Am J Ophthalmol. 2021;225:47–56. 10. Zetterberg M, et al. A composite risk score for capsule complications based on data from the Swedish National Cataract Register: relation to surgery volumes. Ophthalmology. 2021;128:364–371. 11. Narendran N, et al. The Cataract National Dataset electronic multi- centre audit of 55,567 operations: risk stratification for posterior capsule rupture and vitreous loss. Eye (Lond). 2009;23:31–37. 12. Zare M, et al. Risk factors for posterior capsule rupture and vitreous loss during phacoemulsification. J Ophthalmic Vis Res. 2009;4:208–12.

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